Traumatic Brain Injury Treatment
Treatment for traumatic brain injury depends on the extent of the injuries sustained. In most minor cases, doctors instruct patients to rest and let the injury heal on its own. For patients with serious injuries, the treatment is more intensive and may require ongoing care. Regardless of the situation, a victim who has sustained a traumatic brain injury should seek immediate medical attention to treat the injury and prevent complications.
Primary Traumatic Brain Injury Treatment
The first step in treating an open head injury or closed head injury is to perform emergency care to prevent any further damage. Doctors and support staff begin by evaluating the patient's injury and treating any open wounds to prevent infection and blood loss.
Next, doctors work diligently to ensure the patient is receiving adequate air supply and blood flow. This may include placing the patient on a respirator and carefully monitoring the pulse. If necessary, doctors perform cardiopulmonary resuscitation (CPR) and/or defibrillation. To prevent further complications, doctors monitor blood pressure and may place patients on a ventilator to increase blood flow to injured brain tissues. Once a patient has stable vital signs, the doctors create a more detailed treatment plan.
Treating Patients with Closed Head Injuries
Closed head injuries and open head injuries are treated differently. To evaluate closed head injuries, doctors use magnetic resonance imaging (MRI) scans, computerized tomography (CT) scans and X-rays. They also monitor intracranial pressure (ICP).
By definition, closed head injuries do not break the skin or fracture the skull. In minor closed head injuries, patients are given pain medication and told to rest until the injury has healed. After a short period of time, in some cases one week, the doctor evaluates the patient to ensure he or she is healing properly.
Treating moderate to severe closed head injuries may require more invasive medical intervention, including surgery. Patients who demonstrate increased intracranial pressure are at heightened risk for serious brain damage. Because the skull has not been fractured, it does not allow room for the brain to swell. As a result, brain tissues are damaged and blood vessels are torn, causing blood to pool in the brain.
In some cases, intracranial pressure can be treated with medication, including diuretics. More severe cases require surgery to create a "window" in the skull to accommodate swelling and drain excess fluids. Surgery to remove blood clots (hematomas) may also be necessary.
Treating Patients with Open Head Injuries
Unlike patients with closed head injuries, those with open head injuries are at risk for infection. Doctors typically administer antibiotics immediately to prevent or treat infection.
Doctors use various medical technologies to evaluate the extent of the injury, including MRI scans, CT scans, X-rays and ICP monitors.
Depending on the patient's condition, doctors may recommend surgery to remove skull fragments. In some instances, when the skull is fractured, it presses down against the brain, damaging delicate brain tissue. Doctors must work quickly to remove fragments and replace them with synthetic skull pieces.
Doctors must also prevent increased intracranial pressure, which can be treated with medication or surgery. Blood clotting is also monitored and drained, if necessary.
In addition to treating existing injuries, doctors must also prevent the risk of other damage. Because traumatic brain injury can interrupt brain activity, patients have a higher risk of suffering convulsions or seizures, which can lead to further damage.
Ongoing Treatment for Traumatic Brain Injury
Patients who sustain moderate to severe traumatic brain injuries often need ongoing medical treatment. This includes long-term care to monitor the level of consciousness, treat complications and regain lost skills.
Physicians carefully evaluate a patient's level of consciousness based on observations made using the Glasgow Coma Scale or the Rancho Los Amigos Scale. These scales allow doctors to monitor a patient's condition, as well as the success and progress of treatment.
After sustaining severe head injuries, many patients lose basic skills, such as walking, talking, eating, reading and bathing. Physical therapists and other specialists work with patients to help them improve their ability to perform these tasks so that they will be able to function outside of the hospital. The length of treatment depends on the patient's condition and rate of progression.
Many hospitals and traumatic brain injury rehabilitation facilities offer specialty centers for patients with traumatic brain injury. To learn more about traumatic brain injury treatment and rehabilitation, please continue reading All About Traumatic Brain Injury.
[Last revision: July 2009]